Besides the forms already mentioned these neuroses have been known to effect compositors, engravers; seamstresses, tailors, from using the needle or scissors; cobblers; bricklayers, from using the trowel; artificial-flower makers; weavers; milkers; painters; dentists; ballet-dancers, from standing on their toes; blacksmiths and those using the hammer; carpenters, from using the saw and screw-driver; electrical-instrument makers, from winding coils; turners; watchmakers; fencing-masters; cigar-makers; makers of photographers' gelatin plates; knitters and those using the crochet-needle; billiard-players; counters of money; dressers of hides; pedestrians; and a few others.
Writers, telegraph operators, and musicians are those which by far are the most frequently affected, the others being almost curiosities. Among the latter may be mentioned the case, recently coming under my notice, of pain in the right forefinger and arm, with cramp in the former, upon any prolonged attempt to read with this finger the raised letters of the alphabet of the blind. The patient was a blind woman depending for her living upon crocheting, which occupation was also seriously interfered with by this trouble.
After inquiring, in factories, etc., I find that the disease is by no means a recognized one among the workmen. Among telegraphers, however, it is so well known that they have called it the loss of grip, while in France it is known among them as le mal télégraphique.
Gardner,14 after a careful investigation, finds no proof that physical disease originates in, or is even aggravated by, the use of the sewing-machine, and he has “never even heard of a case of cramp.” He comes to this conclusion after having visited many large factories where sewing-machines are used and worked by foot-power; his remarks apply to those machines where the feet are worked together, and not alternately, which last has been known, according to Down,15 to cause serious troubles, of an entirely different kind, however, from the one under consideration, and with which this subject has nothing in common.
14 A. K. Gardner, M.D., “Hygiene of the Sewing-Machine,” Am. Med. Times, Dec 15-29, 1860.
15 “Hygiene of the Sewing-Machine,” London Lancet, 1866, vol. ii. p. 447.
PREDISPOSING CAUSES.—Tobacco and Alcohol.—Both of these articles exert a powerful effect upon the nervous system, tobacco particularly being a factor in the causation of many cases of neurasthenia. The first effect of tobacco and alcohol in small doses on the brain and spinal cord is, according to Boehm and Von Boeck,16 that of an excitant; subsequently it acts as a depressant. Eulenburg17 mentions tremor as of very frequent occurrence, and states that he has frequently noticed it in young cigar-makers who smoke to excess.
16 Ziemssen's Cyclopædia, Amer. ed., vol. xvii.
17 Ibid., vol. xiv.
Cigarettes are more injurious than other forms of tobacco used in smoking, as the smoke is nearly always inhaled, a greater effect being thus produced by a given amount of the drug. Besides this, cigarettes contain a large amount of other substances deleterious in their effects. Trembling of the fingers and hand is frequently seen in those smoking cigarettes freely.